S J Ayub Med Coll Abbottabad 2015;1(2)

ORIGINAL ARTICLE
VISUAL IMPAIRMENT; AN OCCUPATIONAL HAZARD
Junaid Zeb, Rifaq Zeb*, Kishwar Ali**, Irfan Ali, Muhammad Sadam Niaz***, Humera Latif†,
Hamid Ali***
Student Ayub Medical College, Abbottabad, *House Officer, Khyber Teaching Hospital, Peshawar, **Poonch Medical College Rawalakot-AJK,
***Student Khyber Medical College, Peshawar, †Resident, Ayub Teaching Hospital, Abbottabad-Pakistan

Background: The incidence and prevalence of many diseases are highly influenced by occupation. Tailoring
and welding are very important and common occupation in both developed and developing countries. Both
occupations can cause injuries if adequate safety measures are not taken. Unfortunately safety standards
which guide such occupations are lacking in many developing countries including Pakistan. This study was
conducted to know the prevalence of visual impairment among tailors and welders and the degree of
safety measures taken. Methodology: It was a descriptive cross sectional study done in different areas of
Peshawar from June to August 2015. A pre designed questionnaire was distributed among welders and
tailors aged between 12–60 years. Data was collected and analysed through SPSS-21. Results: Out of 124
welders in Peshawar, 7.3% had visual impairment. Out of total respondent among welders 89.7% reported
using protective eye devices while 10.3% did not use any protective devices. There was significant
association between visual impairment and use of protective eye devices ( p<0.05). Among tailors a
prevalence rate of 5.1% for visual impairment was noted. Out of total 77 tailors, 64.9% did not consider
tailoring as hazardous to vision. It was also found that a good proportion (19.5%) of tailors didn’t have
proper illumination at their work place required to prevent visual impairment. Conclusion: Welding and
tailoring among many other occupations are associated with visual impairment at workplace. Awareness
among the affected population is lacking and this needs to be targeted.
Keywords: Welders, tailors, Peshawar, visual impairment
Stud J Ayub Med Coll Abbottabad 2015;1(2):41–5

INTRODUCTION working place occur in manufacturing, service and

11
Occupational health is an important aspect of construction industries. 81% of work related
12
1
medicine. The incidence and prevalence of many ocular injuries occur in men aged 25 to 44 years.
2 Studies from Nigeria reported work related ocular
diseases are highly influenced by occupation. In
modern era the harmful effects due to chronic injuries in which 6.6–44% cases were due to
exposure to low level of harmful factors at work exposure to chemical burns, welder’s arc burn and
13–15
3
place is an important issue. In Pakistan a lot of corneal foreign body and most of them were
people are associated with tailoring and welding because of lack of safety measures. Welding is a
work among other who are vulnerable to visual useful process and it contains ultraviolet B as main
impairment. Rules are made regarding exposure to source. It is also a source of intense optical
16–19
damaging substance in industries but still a lot of radiations. In countries like Pakistan electric
20
work is needed to prevent these effects in and gas welding are mostly practiced. Long term
population at risk in third world countries like exposure to ultraviolet radiation is associated with
Pakistan. In work place worker interacts with ill effects like pterygium, pingueculae, band-shaped
4 21
physical, chemical, biological agents and machines. keratopathy and climatic droplet keratopathy.
Regular studies are conducted in order to know the Thermal burns can also occur during welding and
22
present and forthcoming problems in work place and can cause skin and ocular injuries. Mainstay of
improve and maintain the highest level of wellbeing ocular protection from welding arc radiation is filter
in workers of all occupations and to protect the being placed in welder’s helmet, made from
23
workers in their working environment from the infrared absorbing green glass.
hazardous effects of many substances.
5 Tailoring, in Pakistan, is a way of livelihood
Ocular injuries an important cause of for a lot of people and unfortunately very little
6 research has been done in this field and no
impaired vision and blindness. Trauma at working
place is responsible for a high percentage of ocular appropriate attention has given regarding safety.
injuries.
7–10
More than half of ocular injuries in Here we have made an attempt to improve the

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wellbeing of tailors and welders, by assessing their
occupational exposure and related risk, who need
special attention because they are mostly
uneducated and poor people and know very little
about their safety in working place.
MATERIAL AND METHODS
A cross sectional study was conducted in which
target population was welders and tailors of
Peshawar including all those who were self-
employed and those working as employees in
shops. Only males between 12–60 years of age
were considered. All welders and tailors whose
visual acuity was less than 6/18 with available
correction were termed as visually impaired, those
whose visual acuity was less than 6/60 were
termed as having severe visual impairment, and
those whose visual acuity was less than 3/60 were
termed as blind. Welders using welding helmets
and goggles during their work were considered as
taking proper safety measures. For tailors an
illumination level of 300–500 lux and maximum 9
hours of work was considered as safe.
Visual acuity assessment was done for
each eye using Snellen chart placed at 6 meter
distance outdoor in day light. Illiterate E chart was
used for uneducated workers. Each eye was tested
separately. Data was collected with aid of
questionnaire which included bio data, questions
regarding type of welding, safety knowledge,
history of ocular injury, use and type of protective
device and reason for not using protective device
were asked. A random sample of 201 male workers
was taken including 124 welders and 77 tailors
from different areas of Peshawar. Data was
analysed by using SPSS-21.
RESULTS
A total of 124 welders were examined, out of
which 112 (90.3%) were electric welders and 12
(9.7%) were gas welders (panel beaters). Out of
these, 4 welders were those who used both
electric and gas welding in their life time. All the
welders were males. The age range of the welders
was between 12 to 60 years with a mean age of 31
years+SD12.9 years (Table-1)
A total of 7.3% for visual impairment was
noted among welders of Peshawar at the time of
examination with available correction. The age
group mostly affected was between 45–60 years.
Visual equity assessment showed that number of
welders with visual equity >6/18 with available
correction (normal) were 115 (92.7%) while those
42 http://www.sjamc.ayubmed.edu.pk
S J Ayub Med Coll Abbottabad 2015;1(2)
with <6/18 with available correction (visually
impaired) were 9 (7.3%). Age wise distribution is
given in following figure.
Results also showed that about 27.4%
welders were not aware about safety measure
regarding their occupation hazard while about
23.3% welders didn’t consider welding being
hazardous to vision. From the total respondents,
109 (89.7 %) welders reported using protective
eye devices, while 15 (10.3%) did not use any
protective eye devices. Majority of welders 88%
wore sunglasses at work while a small 3%
proportion was wearing goggle and rest of
welders 9% used helmet or shields.
In our total sample of 124 welders, 112
(90.3%) were electric welders while 12 (9.7%)
were gas welders. Among total electric welders,
106 (94.7%) wore protective devices while 6(5.3%)
did not. While among gas welders 3 (25%) use
protective measures while 9(75%) did not. It
means that use of protective measures is high
among electric welders. Majority reasons of not
using protective measures were that they were
not perceived as useful 47.5% (59) and not
remembering to wear them during work 22.5 (28)
among other
About 56 (45.1%) welders were illiterate
38 (30.6%) had primary education, 23 (18.5 %) had
passed there matriculation exam while 6 (4.8%)
had cleared intermediate level while only 1 (0.8%)
welder was graduate.
Work experience of the welders ranged
from 1–2 years up to more than 35 years. Majority
of welders had work experience of 5–15 years
with a mean of 14 years+SD10.2 years. Detail of
which is given in table-3.
Chi square test was done to find out
association between visual impairment and use of
protective eye devices. The p-value came out to
be less than 0.05 and hence we concluded that
association between visual impairment and use of
protective eye devices is significant.
The age range of the tailors was between 12 to 60
years with a mean age of 32.7 years+SD 11.63
years. Table-4 shows age wise distribution of
tailors.
A total of 5.1% for visual impairment was
noted among tailors of Peshawar at the time of
examination with available correction. The age
group most affected was between 50–60 years.
Visual equity assessment shows that number of
tailors with visual equity >6/18 with available
correction (normal) were 73(94.8%) while those
 S J Ayub Med Coll Abbottabad 2015;1(2)

with <6/18 with available correction (visually Tabe-1: Age wise distribution of welders
impaired) were 4 (5.2%). Age wise distribution is Age group Frequency Percentage (%)
Cumulative
given in figures. percentage (%)
12–18 23 18.5 18.5
Out of total 77 tailors, 64.9% did not
18–24 19 15.3 33.8
consider tailoring as hazardous to vision. While 24–30 19 15.3 49.1
about 59.7% tailors were not aware about safety 30–36 16 12.9 62
measures regarding their occupation. It was also 36–42 17 13.7 75.7
found that a pretty good proportion (19.4%) of 42–48 11 8.8 84.5
tailors did not have proper illumination at their 48–54 10 8.1 92.6
54–60 9 7.3 100
work places required to prevent visual
impairment. Table-2: Reasons of non-use of protective measures
Long working hours constantly focusing Reasons No. of Percentage Cumulative
on tiny objects is another risk factor in visual welders (%) percentage (%)
Forgetfulness 28 22.5 22.5
impairment in tailors. According to our study
Do not think it is useful 59 47.5 70
majority of tailors works for 6–12 hours in a day Inability to see clearly 20 16.1 86.1
while a maximum work of 9 hours is considered as Discomfort 14 11.2 97.3
safe. Cannot afford it 2 1.8 99.1
Our study shows that about 30 (39.1%) Other reasons 1 0.9 100
tailors were illiterate, 31 (40.2%) had primary Table-3: Distribution of workers according to
education, 15 (19.4%) had passed their working experience
matriculation while only 1 (1.2%) had studied up Work experience Percentage Cumulative
(years) No. of welders % percentage (%)
to intermediate level.
0–5 35 28.2 28.2
Working experience of tailors ranged 5–10 12 9.6 37.8
from 1–2 years up to more than 35 years. Majority 10–15 29 23.3 61.1
15–20 16 12.9 74
of tailors had working experience of 5–15 years 20–25 14 11.5 85.5
with a mean of 12.72 years with +SD8.25 years. 25–30 8 6.4 92
30–35 6 4.8 96.8
>35 4 3.2 100

Table-4: Age wise distribution of tailors

Age Frequency Percentage Cumulative
group % percentage (%)
12–18 7 9.0 9.0
18–24 18 23.3 23.3
24–30 12 15.5 48.8
30–36 13 16.9 65.7
36–42 11 14.2 79.9
42–48 7 9 88.9
48–54 4 5.1 94
54–60 5 6.0 100

Table-5: Working hour’s detail

Figure-1: Age group mostly affected No. of working hours No. of tailors
<3 1
3–6 4
6–9 32
9–12 38
12–15 2

Table-6: Detail of working experience of tailors

Work experience No. of Percentage Cumulative
(in years) tailors % percentage (%)
0–5 14 18.1 18.1
5–10 20 26 44.1
10–15 21 27.2 71.3
15–20 8 10.3 81.6
20–25 6 7.7 89.3
25–30 4 5.1 94.4
30–35 3 3.8 98.7
Figure-2: Age group mostly affected >35 1 1.3 100

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DISCUSSION
The prevalence of visual impairment in our study
was 7.3% among welders of Peshawar. The age
group most affected was between 45–60 years.
Most of welders were illiterate. Majority of our
welders were having experience of 5–15 years. Chi
square test was done to find out association
between visual impairment and use of protective
eye devices and was found out to be significant with
a p value of less than 0.05.
The study also reveals that a small
proportion of welders in Peshawar did not take
adequate precautions to protect their eyes from
hazards associated with welding. This finding is
attributed to absence of ocular health safety
standards in the country and inadequate knowledge
of the potential occupational hazards by the
welders. These results will be a strong tool in
persuading the health authorities of the need to
establish a committee to set safety standards,
monitor compliance and to educate the welders and
allied workers about the occupational hazards
associated with profession and the need to take
adequate safety precautions.
In our study various reasons were given for
not wearing protective eye devices .These included
that the goggles are too thick and interfere with
visibility therefore impairing the welder’s ability to
do their work effectively. This reason was given by
those who preferred sunglasses, and those who
were gas welders and not using any protective eye
devices. Main reasons of not wearing protective eye
devices are: Do not think it is useful (47.5%),
Forgetfulness (22.5%), Inability to see clearly
(16.1%), Discomfort (11.2%), Cannot afford it (1.8%),
other reasons (0.9%). The gas welders were either
ignorant of their use or did not feel they were
necessary for their work and did not think exposure
of their eyes to the flame of oxy acetylene gas had
any effect on their eyes.
In a survey of the eye safety practices
among welders in Nigeria, 43.7% of the welders
wore goggles, 45.4% used sunglasses, while 10.9%
did not use any device. In this study only 9% of the
welders wore goggle which is very low. Most of the
workers (88%) used sunglasses.
The prevalence of visual impairment in the
study was 5.1% among tailors of Peshawar. Out of
total 77tailors studied 64.9% did not consider
tailoring as hazardous to vision. While about 59.7%
tailors were not aware about safety measures
regarding their occupation. It was also found that a
44 http://www.sjamc.ayubmed.edu.pk
S J Ayub Med Coll Abbottabad 2015;1(2)
pretty good proportional of tailors do not have
proper illumination at their work places required to
prevent visual impairment. Actually 15 (19.4%) out
of total 77 tailors don’t have proper illumination
system at their work place require to prevent visual
impairment. The possible reason for the people
resorting to this field as their occupation is most
definitely due to lack of proper education and
learning facilities available and/or affordable to
them. The people engaged in tailoring occupation
faces a tough time tackling the occupational health
problems. Musculoskeletal, dermal, ocular, and
psycho-social problems form the key category of
health problems found among them. Our study is
24–27
supported by some international studies.
CONCLUSION
Welding and tailoring among many other
occupations are the one associated with visual
impairment at workplace. Our study showed a
significant association between visual impairment
and lack of proper safety measures at work.
Awareness among the affected population is lacking
and this needs to be targeted.
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Correspondence:
Junaid Zeb, Student, Ayub Medical College, Abbottabad-Pakistan
Cell: +92 3429070725
Email: Junaidzeb100@gmail.com

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